Fertility control and the medical profession

The results of a survey of attitudes of the medical profession carried out in northeast Scotland are discussed. In Aberdeen there is a low birthrate, a low proportion of women with 4 or more children, and low stillbirth and perinatal mortality rates. The total illegitimate pregnancies have risen from 181 in 1961 to 564 in 1973. Many doctors dislike the procedure of termination of pregnancies, and some surgeons find performance of vasectomy distasteful. General practitioners felt that they should give contraceptive advice, and gynecologists considered fertility control part of their specialty. Counseling is essentially a social work skill, and perhaps the social worker is the proper person to do the counseling. A most urgent problem is how to fit contraceptive services to the needs of different sectors of the population. The standards of medical care in northeast Scotland are among the highest in the country. The family doctor is the source of professional contraceptive advice for most women. Doctors would have to be much more active in family planning to provide an effective service. General practitioners need to improve their skill in family planning work. Abortion is accepted as part of the fertility control service. Doctors were unclear about criteria for sterilization. It was implied that education about the risks would decrease illegitimate pregnancies. There were more reservations about sterilizing women than about sterilizing men. Surgeons tended to see performing male sterilization as a favor if it was not required on medical grounds.